AUSTIN, Texas, July 6, 2026
Natera, Inc. has announced the publication of groundbreaking clinical data in JAMA Oncology demonstrating that its Signatera™ personalized molecular residual disease (MRD) test can predict which patients with resected metastatic colorectal cancer are most likely to benefit from adjuvant chemotherapy (ACT). The findings, which were also presented during the 2026 European Society for Medical Oncology Gastrointestinal (ESMO GI) Congress, represent the first large-scale evidence showing that MRD status predicts an overall survival benefit from adjuvant chemotherapy in patients with colorectal liver metastases (CRLM). The study analyzed 298 patients enrolled in the GALAXY trial, the prospective observational arm of CIRCULATE-Japan, with a median follow-up of 43 months. The results reinforce the growing role of circulating tumor DNA (ctDNA)-based MRD testing in precision oncology by helping physicians personalize treatment decisions, potentially sparing low-risk patients from unnecessary chemotherapy while identifying those most likely to achieve meaningful survival benefits.
Signatera MRD Test Identifies Patients Who Benefit from Chemotherapy
The newly published research demonstrated that Signatera successfully identified MRD-positive patients who experienced significant improvements in both disease-free survival (DFS) and overall survival (OS) following adjuvant chemotherapy after curative-intent surgery. Among patients who underwent surgery without neoadjuvant chemotherapy, MRD-positive individuals receiving ACT achieved a 48-month overall survival rate of 65.3% compared with 32.9% for patients managed with observation alone, highlighting a substantial survival advantage. In contrast, MRD-negative patients showed favorable long-term outcomes regardless of chemotherapy, with no statistically significant survival benefit from ACT.
These findings provide important evidence supporting the use of personalized MRD testing to guide postoperative treatment strategies, allowing oncologists to tailor therapy according to an individual’s residual disease status rather than relying solely on conventional clinicopathologic risk factors. By distinguishing patients who truly benefit from chemotherapy, Signatera has the potential to improve clinical outcomes while reducing unnecessary treatment-related toxicity and healthcare costs.
GALAXY Trial Strengthens Precision Oncology for Colorectal Cancer
Advertisement
The study further confirmed the strong prognostic value of post-surgical MRD assessment in patients with colorectal liver metastases, one of the leading causes of colorectal cancer-related mortality worldwide. Patients who tested MRD-positive between two and ten weeks after surgery experienced significantly poorer disease-free survival and overall survival compared with MRD-negative patients, regardless of whether they had received neoadjuvant chemotherapy before surgery. The findings underscore the importance of circulating tumor DNA analysis as a highly sensitive biomarker capable of detecting microscopic residual disease long before conventional imaging identifies disease recurrence.
Investigators noted that the analysis represents the largest study to date demonstrating that MRD status predicts both disease recurrence and overall survival benefit from adjuvant chemotherapy in patients undergoing surgery for colorectal liver metastases. This evidence supports the growing integration of liquid biopsy technologies into routine oncology practice as clinicians increasingly adopt biomarker-guided treatment strategies that improve personalized cancer care.
Precision Diagnostics Continue to Transform Cancer Treatment Decisions
The publication of these results further strengthens Natera’s leadership in precision medicine and molecular diagnostics, reinforcing the expanding clinical utility of Signatera across multiple cancer types. As a personalized ctDNA-based MRD assay, Signatera analyzes each patient’s unique tumor mutations to detect molecular residual disease with exceptional sensitivity, enabling clinicians to identify recurrence risk, monitor treatment response, and optimize therapeutic decision-making. Backed by more than 400 peer-reviewed publications, Natera’s diagnostic platform continues to generate evidence supporting its role in advancing individualized cancer management.
The GALAXY trial findings represent an important milestone in the evolution of precision oncology, demonstrating how molecular diagnostics can guide adjuvant treatment selection and improve long-term patient outcomes. As healthcare systems increasingly embrace biomarker-driven medicine, MRD-guided treatment strategies are expected to play an increasingly important role in delivering more personalized, effective, and evidence-based cancer care for patients with colorectal cancer and other solid tumors.
Source: Natera press release
